Third key state
mental health
official resigns

The departures come
with court-ordered
improvements unmet

Dr. Thomas W. Hester, who guided the state mental health system through critical court-ordered changes the past four years, has resigned as Adult Mental Health Division chief.

Thomas Hester: Chief of adult mental health is praised for openness and patience

Hester is the third key management official to resign from the division. Others are Paul Guggenheim, Hawaii State Hospital administrator, and Dr. Alan Radke, medical director.

The resignations have raised questions about how the state Health Department can finish improvements in mental services ordered under a lawsuit filed by the U.S. Justice Department in 1991.

All three had a significant role in achieving changes required at the state hospital in Kaneohe. It was released from court oversight in December. But the court still is overseeing work on a community mental health plan, which must be completed by June 2006.

Radke left a few weeks ago for Minnesota, returning to a position he previously held as medical director for the state Department of Human Services.

Guggenheim resigned, effective Friday, to return to Ohio for family reasons. He has a new job as chief executive officer of the North Coast Behavioral Health Care System in Northfield, Ohio.

Hester could not be reached for comment.

Hester and Guggenheim were hired in June 2001 after a national recruitment process to expand and improve state mental health services.

Health Director Chiyome Fukino, presently in Washington, D.C., said: "Dr. Hester's leaving is a loss to the state. He has provided tremendous leadership in the area of adult mental health over the last few years.

"He has helped to improve accessibility to services, provided individuals with severe and chronic mental illness with a voice in the system, and has facilitated new streams of federal funding, bringing in about $11 million in grants to the state."

Hester's contributions "have moved the state much closer to its goal of developing a quality system of care that is sustainable beyond court involvement," Fukino said.

Michelle Hill, deputy director for behavioral health, said Hester told her Friday he was resigning. "Dr. Hester and I are still talking through his decision," she said. "I have tried to dissuade him. I will continue to do that, if we can address his concerns."

Joanne Lundstrom, chief executive officer of Mental Health Kokua, which provides statewide residential and recovery services for the mentally ill, said she is "shocked and saddened" at Hester's resignation "and now worried."

"To have gotten through the Hawaii State Hospital oversight successfully was a huge accomplishment and the momentum now was in implementation of the community plan," she said. "That meant quite an expansion of community-based services for people in recovery from mental illness, and it's impressive.

"In the absence of leadership, the concern is, what will happen now?"

Hester's departure "will put the state behind years because it's unlikely anyone will have the leadership abilities for what the system needs to be," said Bud Bowles, executive director of United Self-Help. "He brought a consistent consumer-first perspective and he meant it.

"He's given us the warm line (for consumers to talk). He created a monthly feedback where we could come and talk to him. ... He has more patience than I've ever seen with consumers. He has an open-door policy."

Hill said she must try to stabilize the Adult Mental Health Division's administration to assure that the community plan is completed by the deadline and services are continued to consumers and their families.

The challenge, she said, is to comply with 14 items remaining from 88 required in the community mental health plan and be able to sustain the system.

She said Hester has provided solid leadership but "he doesn't see a place for him in achieving the last 14 elements."

Hill said Radke decided to leave because "there were a number of things that caused him to feel concerned about the future direction and role he would play."

"He saw his departure as a positive step to strengthening the infrastructure of the administration and closing in on goals of the community plan," Hill said.

The Hawaii Disability Rights Center, which represents mental health consumers, was pleased with Radke, Hester and Guggenheim, said Ann Collins, vice president.

She said Guggenheim "made such strides at the hospital" and Hester "really has been visionary and has wonderful ideas for community mental health services."

Ken Wilson, Mental Health Association of Hawaii executive director, said: "It's unfortunate that the three of them are leaving, especially in such close proximity of each other. It's going to be difficult for whoever comes in to pick up the plan."